It is sleep disorder characterised
by difficulty in falling and remaining asleep, early morning
awaking, frequent awaking during night, lack of restful sleep.
OR a combination of all the above mentioned things.
It can be a primary disorder
OR it can be a secondary manifestation of psychiatric illness,
anxiety, and drug use for sleep apnea.
History of the patient may
determine whether sleep is disturbed by irregular sleep schedule
and waking up time, afternoon nap,excessive night time noise,
heat, self medication, consumption of alcohol, caffeine and
Insomnia is a disorder in which
one though sleepy is unable to sleep or remains abnormally
awake at night.
So instead of sedating
the patient if one tries to find out the cause of Insomnia
and treat it the effect would be positively safe and long
Causes of Insomnia can be divided
into 2 categories. They are
A] Physical -
In cases of severe pain
Heat or fever
B] Mental -
1) Difficulty in falling asleep.
2) Waking up early morning.Patient
is unable to get back to sleep.
3) Restless, disturbed
sleep &frequent awakening.
4) Associated symptoms
like anxiety, depression, alcoholism, drug abuse.
5) Sleep walking
6) Waking up unrefreshed.
Heaviness in body
Burning of eyes
Loss of interest
Loss of appetite
Treat the underlying condition
Avoid drinking alcohol, tea,
coffee, late in the evening.
Decrease smoking & overeating
Do light exercise before going
to bed (simple walking around 100 steps would be beneficial.)
Behaviour modification, relaxation
techniques and psychological counselling
Drug therapy depending on the
If anxiety is the cause anti-anxiety
If depression is the cause
Short acting sleep inducers.
Sleep maintainers for prolonged
If at all Hypnotics is to be
used, it should be used only for a short time since Long acting
hypnotics may produce hangover AND Hypnotics used for a long
time may worsen the clinical status of the patient.
- Treatment response depends
upon the etiology of insomnia.
- Rebound insomnia may follow
abrupt withdrawal of sedative hypnotic medication.
- Some patients may respond
to nondrug measures once the problem is discussed.
Remedies commonly used for
sleeplessness due to physical causes -
A/F exhausting diseases,
Loss of vital fluids especially haemorrhages, excessive lactation,
Unrefressing sleep or constant stupor,
Wakes up early << at 3 Snoring especially in children.
Dreams anxious frightful and confused state after waking so
that the dream cannot be forgotten nor can be remembered completely.
Mind indulges in castle building.
Mentally indifferent, gloomy.
No desire to live but lacks courage to commit suicide.
Persons especially children
with brown hair, nervous excitable temperament.
Children, newborn and during dentition.
Sleeplessness due to pain.
Drowsiness with moaning Weeping during sleep.
Anxious frightful dreams.
Half open eyes. Restlessness
Oversensitive to pain and irritability.
Snappish, cannot answer politely.
Child wants many things which he refuses when he gets it.
Child quiet only when carried in arms.
MENTAL CALMNESS IS CONTRAINDICATION
Sleeplessness due to congestion
of brain which also leads to furious excitement, perverted
Twitching convulsions, pain.
Talking screaming, starting in sleep.
Restless sleep, crying out kept awake by pulsations of blood
Starting when closing
the eyes or during sleep.
Sleepy but cannot sleep.
Sleeps with hand under head
<< noise,touch, lying down.
Acuteness of all senses,
Hallucinations, sees monsters and hideous faces.
Mentally violent, bites, strikes,desire to escape.
Sleepless from overexertion.
Restlessness. Comatose drowsiness.
Awakens with hot head, coldness of lower part.
Everything on which he lies seems too hard,
Complaints constantly of it and keeps moving from place to
place in search of soft spot.
Dreams of death, mutilated
Anxious terrible dreams,horrors in night.
Involuntary stools during sleep.
Remedies for sleeplessness
due to mental causes -
Coffea, Passiflora, Aquileg,
Ambra Gresia, Ignatia Hyocyamus
Suits all, lean stooping
person, dark complexion.
A/F excitement of any kind good news or joys, night watching,
unsuitable diet, overcrowding of ideas.
Sleepless, wide awake condition, impossible to close the eyes.
Physical excitement through mental exaltation
Unusual activity of mind
and body, full of ideas, quick to act.
Over sensitiveness of all special senses.
Sleeps till 3 a.m. after which there is only dozing.
Sleep disturbed by dreams.
Mentally person is irritable and excited.
Tosses about in anguish
Especially suited in infants
Sleeplessness from mental irritation or pain.
This drug induces sleep as it has quieting effect on nervous
system. Restless and wakeful resisting from exhaustion.
Insomnia due to mental worry and overwork with tendency to
Remedy for sleeplessness due
Hysteria at climaxis (menopause).
Nervous trembling of body.
Sensitive to light and noise.
Especially for young girls
who are excitable nervous and weak or old people with nervous
Thin lean personality.
A/f worry and business
Cannot sleep from worry or business embarrassment, must get
up. Anxious dreams.
Coldness of body and twitching of limbs during sleep.
Mentally there is dread
of people and desire to be alone.
Cannot do anything in presence of others,
Cannot even pass stool or urine in their presence.
Music causes weeping.
Despair. Loathing in life.
Time passes slowly for them.
Brooding on unpleasant things in past or present.
Especially suited to nervous
women of sensitive easily excited nature, dark hair skin mild
Sleeplessness from unpleasant
Suppressed mental suffering, shame, mortification, cares.
Jerking of single limbs or whole body on going to sleep.
Itching of arms and violent yawning.
Dreams continuing for long time troubling the person.
Mentally moods change rapidly in a very short time from joy
to sorrow or laughing to weeping.
Involuntary sighing, Desire to be alone.
Impatient irresolute and quarrelsome.
Contradiction excites anger. Easily offended.
Cannot weep in front of others.
Sleeplessness from nervous
excitement with bewildering ideas and images. Intense sleeplessness.
Convulsions. Start up frightened.
There is a perfect picture of mania of quarrelsome and perverted
Immodesty in acts, gestures and expressions is a characterestic
of this remedy.
Talkative and persist in undressing herself or uncovering
genitals. Mentally patient is jealous afraid of being poisoned,
suspicious. Great hilarity. Inclined to laugh at everything.
1) Kali Phos -
Patient is always thinking about the routine worries.
(Intellectual work related
Excellent nerve remedy.
Causing fatigue and mental tiredness.
Especially suited to children who are studying hard during
exams of school and college with tired feeling.
Fear of failure causing sleeplessness.
Sleepy but cannot sleep.
2) Nat Mur -
Brooding tendencies about emotional
disturbances causes sleeplessness.
Weeps alone in bed at night, remembering the unpleasant evening.
Nervous irritability with high salt intake.
Dwells on past disagreeable events in the life.
Eyes remain open throughout the night.